Claudia Booker is a doula, childbirth educator, breastfeeding counselor and homebirth midwife working in the Washington DC, Maryland, and Northern Virginia area. She has supported over 900 families and has been working in birth for over 12 years- So she has just a tad bit of wisdom on how to best support our birthing people (her website even has an “According to Claudia” section!) We thought we could learn a lot from her, so we sat down and chatted birth “According to Claudia.”

On the need for birth workers to provide culturally specific care:

I think it’s our responsibility [as birth workers] to let clients know of all their options and opportunities especially when it comes to cultural specificity- that culturally specific care is available. For example, I’m an African American woman, been one all my life, born and raised in D.C. I am not culturally specific to a Haitian woman. She’s black. I’m black. She’s a woman. I’m a woman. But I am not specific to her culture. She needs a doula and childbirth educator that are specific to her culture and to her lifestyle. I don’t think the white birth community understands that. In all my practice I’ve never heard of a white midwife or doula say to an African American client, “I would love to work with you, but I need to let you know that in this community we have a wide variety of African American midwives and doulas…” I feel that not giving pregnant people full disclosure of all their resources is just like the stuff that doctors do. How do they know they are making the best choice if they don’t have all the options?

Birth work is based on heart to heart; The client absolutely needs to find practitioners whose heart sings to her heart. But we have to let our clients know of all of their opportunities and then hope that they still come back to work with us. I believe it’s our job [as birth workers] to take this on so that we can work to enable every group, culture, and society to have the best birth they can while we fight for universal change.

On how you empower your clients to be active participants and joint decision makers in their births:

My clients and I spend a great deal of time going over how to best be joint decision makers (Because if you’re not driving the car, don’t be surprised where you end up), active participants (If you don’t understand say, “I don’t understand” and have them explain it until you do) and participate in full disclosure and informed consent (If you don’t understand, don’t say yes.)

To start, I always make sure that I am the right person to be working with that client because maybe there are doulas who are better at dealing with parents who are not interested in being active participants and joint decision makers in their births...Who can work with clients that say “I will never speak up. I’ll never ask a question.” But that’s not me.

And parents need to start practicing before the birth. You need to have conversations prenatally where you are counterpointing with your care providers so that you can get used to being in a position of power. Especially if you are working with a practice with nine million providers. You need to have this conversation with everybody so the providers get to know who you are, and you get to practice having a dialogue from a position of power with your clothes on. It’s hard to start to have a conversation that has a power dynamic when you are sitting there with “the robe of disempowerment on”...The robe with your ass hanging out and your coochie almost showing. It’s hard to stand up for yourself when you’re looking like that! This is something that I really work on.

And then I focus on ways to reinforce the messages that I am giving. For example, I send all of my clients to this one yoga teacher because she’s reinforcing in her classes what they heard in their childbirth class and what they are going to hear from me. They are getting the same message in like sixty different ways. If they can’t hear it from me, or they can’t hear it from the childbirth education teacher, we’re going to keep saying this message until we find a way that really resonates with the client.

On the biggest challenges that come up while working in birth:

As a culture we have lost contact with what our bodies were meant to do and how they were meant to be because we focus our reality as women on what is presented to us in social and mass media. We wear tight jeans where we do get enough air in our bottoms and a nutrient deficient diet so we are getting yeasty. We’re carrying huge $2,000 pocket books on our shoulders, which is causing our pelvis to tilt forward. We’re absorbing xenoestrogens. We’re not supporting our pelvic floor. Every year the shoe gets higher and higher tilting the spine... Our bodies were not designed for this and all of these things are external signs that we have decided are nomenclature for what a woman doesn’t look like, instead of taking any time to go back to the universal energy and recognition of our bodies, and how they function best.

And then there’s the fact that we’re all taking pills and people are choosing to focus on their careers so they are deciding to stop having periods altogether. The internal biological and hormonal forces that we could have had our whole lives to adjust to, become attuned to, get to know, are being turned off. We are not dealing with the internal pieces that respond to the universe, and to nature, and to who we really are because we have chemically turned off these systems. And it’s not always just turn it off, turn it back on. Because when we do decide we are ready for babies It takes the body some time to get back into rhythm. And it may get back into rhythm, or it may not. When we decide we all of a sudden want to be in tune with our bodies, it may feel like its not answering us. And then we start saying, Oh my god, my body’s not responding the way I want it to respond. I can't trust my body. My body’s failing me… But we haven’t been listening for the past however many decades! It may be answering us, but we don’t understand the language that it’s answering us with. And even those who manage to conceive quickly, they have spent most of their adult life having no relationship with any part of their bodies except questions, doubts, and fears, and an overall idea that their bodies may fail them.

And this is where we as birth workers meet them. And it’s our job in what, 10 months? 8 months? 3 months? 3 weeks? to help them start relating differently.

My clientele that are gentrified come to me and say, Oh, I saw The Business of Being Born and I want a natural birth. And so I talk about the birth preference plan at our very first visit becausewhat does “natural” mean? There’s no common definition. It’s like “free-range” “organic”.

I say, OK so what out of that movie do you want? I make them really tell me what they are looking for. What kind of a birth they are prepared to work for. Talking to them about who they really are and coming up with a birth vision that represents their lifestyle, their culture and their commitment.

I always ask people, How do you handle pain? Frustration? Deadlines? Because birth is the day all of those things come together at once. If you were stressed, tired, hungry, your butt hurt, and you had to have your work in tomorrow, how would you proceed? How would you handle yourself? I have everybody talk about it. I like them to write it down because it gives the couple a chance to really talk about it out loud and not just say, “Yeah Babe I really want what you want.” “ Well, no Babe I want whatever you want.”

No. What are you willing to bring to this party? What are you bringing to the party? What’s everybody bringing to the party?

On the change you’d like to see for birthing people:

Respectful maternity care. How do you get respectful maternity care? How do you get a medical system that will assist you and that will respect you? I don’t yet think that we have made much progress on this, except for those who are lucky enough to have the finances to be real consumers. Also, there is this total lack of competence, lack of support and lack of access to accurate information. There are families being sabotaged because they simply don’t have the correct information! This isn’t okay.

We also need to figure out how to build pregnant people’s confidence that she can do it, help her to find peace, for her to appreciate the immense responsibility, the gift, of being someone’s mother. I’m always saying to my clients, You’re already a parent. You're just a parent with a baby inside. You don’t need a stroller right now, but you are somebody’s parent. For everything you do, and everything you say, and everything you eat, and everything that goes on your child is watching you. Let’s think of it that way- Think about this now. There’s a kid who is absolutely relying on everything that you say and do now, not later, now. If women are already thinking of themselves as mothers while pregnant, then they may start thinking about their choices a bit differently.

I would love to see women gathering more in small groups, intergenerational groups. I want people to talk and educate about menstruation in their homes. Ask each other what these experiences are like. Create and foster dialogue from multiple perspectives and identities so that we can learn and share what it’s like to be a woman.